
	Sunday, February 05, 2012

Provet PLUS

Transfer Provet PLUS points into Velocity Points

Please complete this form to transfer your Provet PLUS points into Velocity Points.

Please note Provet PLUS points can only be converted to Velocity Points in minimum of 7500 point multiples (i.e. 5000 Velocity Points)

Please read the Velocity Redemption terms and conditions before registration below.

* Indicates required field

Provet Account Number*
Velocity Membership Number*
Title*
Name/Initials*
Surname*	More information Name must be as appears on your Velocity Membership Card
Contact Phone*
Email address*
Practice Address*
Practice City*
Practice State*
Practice Post Code*
Provet Branch*
Number of points to transfer*	More information here Transfer points must be in multiples of 7,500 Provet PLUS points. 1.5 Provet PLUS points equate to 1 Velocity Point
I accept terms and conditions	Yes No
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